ArticleRespiratory research2018
Pneumonia in patients with cirrhosis: risk factors associated with mortality and predictive value of prognostic models.
Article in Respiratory research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Acute-on-chronic liver failure following pneumonia in an elderly woman with metabolic dysfunction-associated steatotic liver cirrhosis.Clinical journal of gastroenterology · 2026Article
- Burden and Impact of Pneumococcal Pneumonia on Outcomes in Patients With Cirrhosis: A Nationwide Analysis.Gastroenterology research · 2026Article
- The neutrophil-to-albumin ratio is associated with in-hospital mortality in patients with cirrhosis and pneumonia: a multicenter retrospective cohort study.BMC infectious diseases · 2026Article
- Biosocial Determinants of Health Among Patients with Chronic Liver Disease and Liver Cancer.Cancers · 2025Article
- Outcomes and Predictors of Severe Community-acquired Pneumonia Among Adults Admitted to the University of Gondar Comprehensive Specialized Hospital: A Prospective Follow-up Study.Infection and drug resistance · 2023Article
- Machine learning to identify risk factors associated with the development of ventilated hospital-acquired pneumonia and mortality: implications for antibiotic therapy selection.Frontiers in medicine · 2023Article
- CLIF-SOFA and CLIF-C scores for the prognostication of acute-on-chronic liver failure and acute decompensation of cirrhosis: A systematic review.World journal of hepatology · 2022Article
- Development and validation of a nomogram for predicting overall survival in cirrhotic patients with acute kidney injury.World journal of gastroenterology · 2022Article
- Review
- Association between viral hepatitis and increased risk of severe coronavirus disease 2019 (COVID-19) outcome: a systematic review and meta-analysis.Gastroenterology and hepatology from bed to bench · 2022Review
- Safety of laparoscopic pancreaticoduodenectomy in patients with liver cirrhosis using propensity score matching.PloS one · 2021Article
- Clinical Characteristics and Outcomes of Coronavirus Disease 2019 Among Patients With Preexisting Liver Disease in the United States: A Multicenter Research Network Study.Gastroenterology · 2020Article
- NF-κB RelA Is Required for Hepatoprotection during Pneumonia and Sepsis.Infection and immunity · 2019Article
- Spectrum of respiratory viral infections in liver disease patients with cirrhosis admitted in critical care unit.Journal of laboratory physiciansArticle
- Prevalence and Predictors for Respiratory Viral Infections among Liver Disease Patients.Euroasian journal of hepato-gastroenterologyArticle
- Hepatic manifestations and impact of COVID-19 on the cirrhotic patient.Revista de gastroenterologia de Mexico (English)Review
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11 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundCirrhosis always goes with profound immunity compromise, and makes those patients easily be the target of pneumonia. Cirrhotic patients with pneumonia have a dramatically increased mortality. To recognize the risk factors of mortality and to optimize stratification are critical for improving survival rate.
methodsTwo hundred and three cirrhotic patients with pneumonia at a tertiary care hospital were included in this retrospective study. Demographical, clinical and laboratory parameters, severity models and prognosis were recorded. Multivariate Cox regression analysis was used to identify independent predictors of 30-day and 90-day mortality. Area under receiver operating characteristics curves (AUROC) was used to compare the predictive value of different prognostic scoring systems.
resultsPatients with nosocomial acquired or community acquired pneumonia indicated similar prognosis after 30- and 90-day follow-up. However, patients triggered acute-on-chronic liver failure (ACLF) highly increased mortality (46.4% vs 4.5% for 30-day, 69.6% vs 11.2% for 90-day). Age, inappropriate empirical antibiotic therapy (HR: 2.326 p = 0.018 for 30-day and HR: 3.126 p < 0.001 for 90-day), bacteremia (HR: 3.037 p = 0.002 for 30-day and HR: 2.651 p = 0.001 for 90-day), white blood cell count (WBC) (HR: 1.452 p < 0.001 for 30-day and HR: 1.551 p < 0.001 for 90-day) and total bilirubin (HR: 1.059 p = 0.002 for 90-day) were independent factors for mortality in current study. Chronic liver failure-sequential organ failure assessment (CLIF-SOFA) displayed highest AUROC (0.89 and 0.90, 95% CI: 0.83-0.95 and 0.85-0.95 for 30-day and 90-day respectively) in current study.
conclusionsThis study found age, bacteremia, WBC, total bilirubin and inappropriate empirical antibiotic therapy were independently associated with increased mortality. Pneumonia triggered ACLF remarkably increased mortality. CLIF-SOFA was more accurate in predicting mortality than other five prognostic models (model for end-stage liver disease (MELD), MELD-Na, quick sequential organ failure assessment (qSOFA), pneumonia severity index (PSI), Child-Turcotte-Pugh (CTP) score).
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